Doctors are faced with the challenge of making treatment decisions for patients on a daily basis, often juggling a busy schedule and a multitude of options. The balance between having too few choices, which can limit care, and too many choices, which can lead to decision fatigue, is a delicate one. However, a recent study conducted by researchers from Northwestern University and the University of Sydney has shed light on a potential solution to this dilemma.
The study, published in JAMA Network Open, involved 402 primary care physicians in the U.S. The researchers aimed to identify the optimal number of treatment alternatives that should be presented to physicians in the electronic health record (EHR) system to improve decision-making. They found that offering two or more appropriate treatment options significantly increased the likelihood of physicians selecting a high-quality alternative, as opposed to defaulting to the status quo.
Dr. Jeffrey Linder, chief of general internal medicine at Northwestern University Feinberg School of Medicine, emphasized the importance of providing physicians with thoughtfully curated prompts in the EHR system to guide them towards evidence-based alternatives. By presenting physicians with just the right number of options, health systems can support better care on a large scale.
Lead author Gemma Altinger, an applied behavioral economist and Ph.D. candidate at the University of Sydney, highlighted the potential impact of simple changes in EHR design on improving care outcomes. The study challenged the notion that more choices could lead to “status-quo bias” and poorer decisions, as it found no evidence of this bias among the participating physicians.
In the study, physicians were presented with scenarios involving surgery referral for hip osteoarthritis and opioid prescribing for back pain. They were asked to choose between the current management plan or an alternative option. The findings suggested that providing two appropriate alternatives in the EHR system was the most effective approach, as adding more options did not further improve decision-making.
Overall, the study underscores the importance of optimizing the design of EHR systems to support physicians in making informed and evidence-based treatment decisions. By striking the right balance in the number of treatment alternatives presented to physicians, health systems can empower doctors to deliver high-quality care to their patients.
